视网膜小血管直径与脑内血管周围间隙扩大相关。
Retinal Microvascular Calibers Are Associated With Enlarged Perivascular Spaces in the Brain.
机构信息
From the Departments of Epidemiology (U.M., H.H.H.A., A.H., C.C.W.K., M.W.V., M.K.I., M.A.I.), Ophthalmology (U.M., C.C.W.K.), Radiology (H.H.H.A., A.v.d.L., M.W.V., M.A.I.), Neurology (M.A.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.); Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.); and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (M.K.I.).
出版信息
Stroke. 2016 May;47(5):1374-6. doi: 10.1161/STROKEAHA.115.012438. Epub 2016 Mar 15.
BACKGROUND AND PURPOSE
Perivascular enlargement in the brain is a putative imaging marker for microvascular brain damage, but this link has not yet been confirmed using direct in vivo visualization of small vessels. We investigated the relation between microvascular calibers on retinal imaging and enlarged perivascular spaces (ePVSs) on brain magnetic resonance imaging.
METHODS
We included 704 participants from the Rotterdam study. Retinal arteriolar and venular calibers were measured semiautomatically on fundus photographs. ePVSs were counted in the centrum semiovale, basal ganglia, hippocampus, and mesencephalon, using a standardized rating method. We determined the association between retinal microvascular calibers and ePVSs with negative binomial regression models, adjusting for age, sex, the other vascular caliber, structural brain magnetic resonance imaging markers, and cardiovascular risk factors.
RESULTS
Both narrower arteriolar and wider venular calibers were associated with more ePVSs in the centrum semiovale and hippocampal region. Rate ratios (95% confidence interval) for arterioles in the centrum semiovale and hippocampus were 1.07 (1.01-1.14) and 1.13 (1.04-1.22), respectively, and for venules 1.08 (1.01-1.16) and 1.09 (1.00-1.18), respectively. These associations were independent from other brain magnetic resonance imaging markers and cardiovascular risk factors.
CONCLUSIONS
Retinal microvascular calibers are related to ePVSs, confirming the putative link between microvascular damage and ePVSs.
背景与目的
脑内血管周围间隙扩大被认为是微血管脑损伤的一种潜在影像学标志物，但这一关联尚未通过对小血管的直接活体可视化来证实。我们研究了视网膜成像中小血管口径与脑磁共振成像中血管周围间隙扩大（ePVS）之间的关系。
方法
我们纳入了 Rotterdam 研究中的 704 名参与者。使用眼底照片半自动测量视网膜动、静脉口径。使用标准化评分方法，在大脑半卵圆中心、基底节、海马和中脑计数 ePVS。我们使用负二项回归模型确定视网膜微血管口径与 ePVS 之间的关联，调整年龄、性别、其他血管口径、结构磁共振成像标志物和心血管危险因素。
结果
较窄的视网膜小动脉和较宽的视网膜小静脉口径与大脑半卵圆中心和海马区的 ePVS 增多相关。大脑半卵圆中心和海马区的小动脉的比值比（95%置信区间）分别为 1.07（1.01-1.14）和 1.13（1.04-1.22），小静脉的比值比分别为 1.08（1.01-1.16）和 1.09（1.00-1.18）。这些关联独立于其他脑磁共振成像标志物和心血管危险因素。
结论
视网膜微血管口径与 ePVS 相关，证实了微血管损伤与 ePVS 之间的潜在联系。
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